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CDC changes course on indoor masks in some parts of the US

CDC changes course on indoor masks in some parts of the US

The Centers for Disease Control and Prevention changed course Tuesday on some masking guidelines, recommending that even vaccinated people return to wearing masks indoors in parts of the U.S. where the delta variant of the coronavirus is fueling infection surges.Citing new information about the variant’s ability to spread among vaccinated people, the CDC also recommended indoor masks for all teachers, staff, students and visitors at schools nationwide, regardless of vaccination status.In other developments, President Joe Biden said his administration was considering requiring all federal workers to get vaccinated. His comments came a day after the Department of Veterans Affairs became the first federal agency to require its health care workers receive the vaccine.Biden dismissed concerns that the new masking guidance could invite confusion, saying Americans who remain unvaccinated are the ones who are “sowing enormous confusion.”“The more we learn about this virus and the delta variation, the more we have to be worried and concerned. And there’s only one thing we know for sure — if those other 100 million people got vaccinated, we’d be in a very different world,” he said.The White House quickly pivoted on its own masking guidance, asking all staff and reporters to wear masks indoors because the latest CDC data shows that Washington faces a substantial level of coronavirus transmission.The CDC’s new mask policy follows recent decisions in Los Angeles and St. Louis to revert to indoor mask mandates amid the spike in COVID-19 infections. The nation is averaging more than 57,000 cases a day and 24,000 COVID-19 hospitalizations.The guidance on masks in indoor public places applies in parts of the U.S. with at least 50 new cases per 100,000 people in the last week. That includes 60 percent of U.S. counties, officials said. New case rates are particularly high in the South and Southwest, according to a CDC tracker. In Arkansas, Louisiana and Florida, every county has a high transmission rate.Most new infections in the U.S. continue to be among unvaccinated people. So-called breakthrough infections, which generally cause milder illness, can occur in vaccinated people. When earlier strains of the virus predominated, infected vaccinated people were found to have low levels of virus and were deemed unlikely to spread the virus much, CDC Director Dr. Rochelle Walensky said.But with the delta variant, a mutated and more transmissible version of the virus, the level of virus in infected vaccinated people is “indistinguishable” from the level of virus in the noses and throats of unvaccinated people, Walensky said.The data emerged over the last couple of days from over 100 samples from several states and one other country. It is unpublished, and the CDC has not released it. But “it is concerning enough that we feel like we have to act,” Walensky said.Vaccinated people “have the potential to spread that virus to others,” she said.For much of the pandemic, the CDC advised Americans to wear masks indoors and outdoors if they were within 6 feet of one another.Then in April, as vaccination rates rose sharply, the agency eased its guidelines on the wearing of masks outdoors, saying that fully vaccinated Americans no longer needed to cover their faces unless they were in a big crowd of strangers. In May, the guidance was eased further, allowing fully vaccinated people to stop wearing masks outdoors in crowds and in most indoor settings.The guidance still called for masks in crowded indoor settings, like buses, planes, hospitals, prisons and homeless shelters, but it cleared the way for reopening workplaces and other venues.Subsequent CDC guidance said fully vaccinated people no longer needed to wear masks at schools either.For months, COVID cases, deaths and hospitalizations were falling steadily, but those trends began to change at the beginning of the summer as the delta variant began to spread widely, especially in areas with lower vaccination rates.Some public health experts said they thought the earlier CDC decision was based on good science. But those experts were also critical, noting that there was no call for Americans to document their vaccination status, which created an honor system. Unvaccinated people who did not want to wear masks in the first place saw it as an opportunity to do what they wanted, they said.“If all the unvaccinated people were responsible and wore mask indoors, we would not be seeing this surge,” said Dr. Ali Khan, a former CDC disease investigator who now is dean of the University of Nebraska’s College of Public Health.Lawrence Gostin, a public health law professor at Georgetown University, drew a similar conclusion.“It was completely foreseeable that when they (the CDC) made their announcement, masking would no longer be the norm, and that’s exactly what’s happened,” Gostin said.The CDC may be seen as “flip-flopping,” he said, because there’s been no widely recognized change in the science, he said. Furthermore, it’s not likely to change the behavior of the people who most need to wear masks.“I don’t think you can effectively walk that back,” he said.The changes were sure to renew mask debates in school districts across the country.In South Florida, the Broward County school board postponed a meeting Tuesday about whether students should wear masks in the classroom this fall after about 20 anti-mask protestors refused to don them. The delay angered the protestors, who called on Gov. Ron DeSantis, a strong mask mandate opponent, and the state government to override any mandates imposed by school districts.“We need a special session of the state Legislature to ban this kind of crap right now,” said Chris Nelson, 38, founder of an anti-mask group called Reopen South Florida. He threatened to go to board members’ homes to confront them directly.“If we can’t be heard in public areas, and peacefully, we will go to where they are, and we will let them know how we feel about this, because we will not stand for children being masked for another year,” he said.Walensky said she is aware of the criticisms and concerns, and she acknowledged that many Americans are weary of the pandemic and do not want to return to prevention measures. But she said new scientific information forced the decision to change the guidance again.“This is not something that I took lightly,” she said.Ken Thigpen, a retired respiratory therapist who now works for a medical device manufacturer, is fully vaccinated and stopped wearing his mask in public in May. But he started to reconsider in the last week after his job took him to hospitals in Mississippi, Louisiana, Alabama and Florida, where he witnessed medical centers getting inundated with COVID-19 patients.“That delta variant is intense. It is so transmissible that we have to do something to tamp it down,” he said.“I loved it when I could call the hospitals and they said, ‘We actually closed our COVID ward today or we are down to two COVID patients,’” he recalled. “And now we are opening the wards back up, and the numbers are going nuts.”———Associated Press writers Aamer Madhani and Alexandra Jaffe in Washington and Heather Hollingsworth in Mission, Kansas, contributed to this report.———The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

'Superbug' fungus spread in 2 cities, health officials say

'Superbug' fungus spread in 2 cities, health officials say

U.S. health officials say they now have evidence that an untreatable “superbug” fungus has spread in two hospitals and a nursing homeBy MIKE STOBBE AP Medical WriterJuly 22, 2021, 10:59 PM• 3 min readShare to FacebookShare to TwitterEmail this articleNEW YORK — U.S. health officials said Thursday they now have evidence of an untreatable fungus spreading in two hospitals and a nursing home.The “superbug” outbreaks were reported in a Washington, D.C, nursing home and at two Dallas-area hospitals, the Centers for Disease Control and Prevention reported. A handful of the patients had invasive fungal infections that were impervious to all three major classes of medications.“This is really the first time we’ve started seeing clustering of resistance” in which patients seemed to be getting the infections from each other, said the CDC’s Dr. Meghan Lyman.The fungus, Candida auris, is a harmful form of yeast that is considered dangerous to hospital and nursing home patients with serious medical problems. It is most deadly when it enters the bloodstream, heart or brain. Outbreaks in health care facilities have been spurred when the fungus spread through patient contact or on contaminated surfaces.Health officials have sounded alarms for years about the superbug after seeing infections in which commonly used drugs had little effect. In 2019, doctors diagnosed three cases in New York that were also resistant to a class of drugs, called echinocandins, that were considered a last line of defense.In those cases, there was no evidence the infections had spread from patient to patient — scientists concluded the resistance to the drugs formed during treatment.The new cases did spread, the CDC concluded.In Washington, D.C., a cluster of 101 C. auris cases at a nursing home dedicated to very sick patients included three that were resistant to all three kinds of antifungal medications. A cluster of 22 in two Dallas-area hospitals included two with that level of resistance. The facilities weren’t identified.Those cases were seen from January to April. Of the five people who were fully resistant to treatment, three died — both Texas patients and one in Washington.Lyman said both are ongoing outbreaks and that additional infections have been identified since April. But those added numbers were not reported.Investigators reviewed medical records and found no evidence of previous antifungal use among the patients in those clusters. Health officials say that means they spread from person to person.———The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

US life expectancy in 2020 saw biggest drop since WWII

US life expectancy in 2020 saw biggest drop since WWII

NEW YORK — U.S. life expectancy fell by a year and a half in 2020, the largest one-year decline since World War II, public health officials said Wednesday. The decrease for both Black Americans and Hispanic Americans was even worse: three years.The drop spelled out by the Centers for Disease Control and Prevention is due mainly to the COVID-19 pandemic, which health officials said is responsible for close to 74% of the overall life expectancy decline. More than 3.3 million Americans died last year, far more than any other year in U.S. history, with COVID-19 accounting for about 11% of those deaths.Black life expectancy has not fallen so much in one year since the mid-1930s, during the Great Depression. Health officials have not tracked Hispanic life expectancy for nearly as long, but the 2020 decline was the largest recorded one-year drop.The abrupt fall is “basically catastrophic,” said Mark Hayward, a University of Texas sociology professor who studies changes in U.S. mortality.Killers other than COVID-19 played a role. Drug overdoses pushed life expectancy down, particularly for whites. And rising homicides were a small but significant reason for the decline for Black Americans, said Elizabeth Arias, the report’s lead author.Other problems affected Black and Hispanic people, including lack of access to quality health care, more crowded living conditions, and a greater share of the population in lower-paying jobs that required them to keep working when the pandemic was at its worst, experts said.Life expectancy is an estimate of the average number of years a baby born in a given year might expect to live. It’s an important statistical snapshot of a country’s health that can be influenced both by sustained trends such as obesity as well as more temporary threats like pandemics or war that might not endanger those newborns in their lifetimes.For decades, U.S. life expectancy was on the upswing. But that trend stalled in 2015, for several years, before hitting 78 years, 10 months in 2019. Last year, the CDC said, it dropped to about 77 years, 4 months.Other findings in the new CDC report:—Hispanic Americans have longer life expectancy than white or Black Americans, but had the largest decline in 2020. The three-year drop was the largest since the CDC started tracking Hispanic life expectancy 15 years ago.—Black life expectancy dropped nearly three years, to 71 years, 10 months. It has not been that low since 2000.—White life expectancy fell by roughly 14 months to about 77 years, 7 months. That was the lowest the lowest life expectancy for that population since 2002.—COVID-19’s role varied by race and ethnicity. The coronavirus was responsible for 90% of the decline in life expectancy among Hispanics, 68% among white people and 59% among Black Americans.—Life expectancy fell nearly two years for men, but about one year for women, widening a longstanding gap. The CDC estimated life expectancy of 74 years, 6 months for boys vs. 80 years, 2 months for girls.More than 80% of last year’s COVID deaths were people 65 and older, CDC data shows. That actually diminished the pandemic’s toll on life expectancy at birth, which is swayed more by deaths of younger adults and children than those among seniors.That’s why last year’s decline was just half as much as the three-year drop between 1942 and 1943, when young soldiers were dying in World War II. And it was just a fraction of the drop between 1917 and 1918, when World War I and a Spanish flu pandemic devastated younger generations.Life expectancy bounced back after those drops, and experts believe it will this time, too. But some said it could take years.Too many people have already died from COVID-19 this year, while variants of the coronavirus are spreading among unvaccinated Americans — many of them younger adults, some experts said.”We can’t. In 2021, we can’t get back to pre-pandemic” life expectancy, said Noreen Goldman, a Princeton University researcher.———The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

US overdose deaths hit record 93,000 in pandemic last year

US overdose deaths hit record 93,000 in pandemic last year

NEW YORK — Overdose deaths soared to a record 93,000 last year in the midst of the COVID-19 pandemic, the U.S. government reported Wednesday.That estimate far eclipses the high of about 72,000 drug overdose deaths reached the previous year and amounts to a 29% increase.“This is a staggering loss of human life,” said Brandon Marshall, a Brown University public health researcher who tracks overdose trends.The nation was already struggling with its worst overdose epidemic but clearly “COVID has greatly exacerbated the crisis,” he added.Lockdowns and other pandemic restrictions isolated those with drug addictions and made treatment harder to get, experts said.Jordan McGlashen died of a drug overdose in his Ypsilanti, Michigan, apartment last year. He was pronounced dead on May 6, the day before his 39th birthday.“It was really difficult for me to think about the way in which Jordan died. He was alone, and suffering emotionally and felt like he had to use again,” said his younger brother, Collin McGlashen, who wrote openly about his brother’s addiction in an obituary.Jordan McGlashen’s death was attributed to heroin and fentanyl.While prescription painkillers once drove the nation’s overdose epidemic, they were supplanted first by heroin and then by fentanyl, a dangerously powerful opioid, in recent years. Fentanyl was developed to treat intense pain from ailments like cancer but has increasing been sold illicitly and mixed with other drugs.“What’s really driving the surge in overdoses is this increasingly poisoned drug supply,” said Shannon Monnat, an associate professor of sociology at Syracuse University who researches geographic patterns in overdoses. “Nearly all of this increase is fentanyl contamination in some way. Heroin is contaminated. Cocaine is contaminated. Methamphetamine is contaminated.”Fentanyl was involved in more than 60% of the overdose deaths last year, CDC data suggests.There’s no current evidence that more Americans started using drugs last year, Monnat said. Rather, the increased deaths most likely were people who had already been struggling with addiction. Some have told her research team that suspensions of evictions and extended unemployment benefits left them with more money than usual. And they said “when I have money, I stock up on my (drug) supply,” she said.Overdose deaths are just one facet of what was overall the deadliest year in U.S. history. With about 378,000 deaths attributed to COVID-19, the nation saw more than 3.3 million deaths.The Centers for Disease Control and Prevention reviewed death certificates to come up with the estimate for 2020 drug overdose deaths. The estimate of over 93,000 translates to an average of more than 250 deaths each day, or roughly 11 every hour.The 21,000 increase is the biggest year-to-year jump since the count rose by 11,000 in 2016.More historical context: According to the CDC, there were fewer than 7,200 total U.S. overdose deaths reported in 1970, when a heroin epidemic was raging in U.S. cities. There were about 9,000 in 1988, around the height of the crack epidemic.The CDC reported that in 2020 drug overdoses increased in all but two states, New Hampshire and South Dakota.Kentucky’s overdose count rose 54% last year to more than 2,100, up from under 1,400 the year before. There were also large increases in South Carolina, West Virginia and California. Vermont had the largest jump, of about 58%, but smaller numbers — 118 to 186.The proliferation of fentanyl is one reason some experts do not expect any substantial decline in drug overdose deaths this year. Though national figures are not yet available, there is data emerging from some states that seems to support their pessimism. Rhode Island, for example, reported 34 overdose deaths in January and 37 in February — the most for those months in at least five years.For Collin McGlashen, last year was “an incredibly dark time” that began in January with the cancer death of the family’s beloved patriarch.Their father’s death sent his musician brother Jordan into a tailspin, McGlashen said.“Someone can be doing really well for so long and then, in a flash, deteriorate,” he said.Then came the pandemic. Jordan lost his job. “It was kind of a final descent.”———The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Experts: Benefits of COVID vaccine outweigh small heart risk

Experts: Benefits of COVID vaccine outweigh small heart risk

Federal officials say they plan to strengthen cautions about a rare side effect of some COVID-19 vaccines — chest pain and heart inflammation, mostly among teenagers and young adultsBy MIKE STOBBE AP Medical WriterJune 23, 2021, 10:24 PM• 3 min readShare to FacebookShare to TwitterEmail this articleNEW YORK — Federal officials said Wednesday they plan to strengthen cautions about a rare side effect of some COVID-19 vaccines — chest pain and heart inflammation, mostly among teenagers and young adults.But in an unusual joint statement, top U.S. government health officials, medical organizations, laboratory and hospital associations and others stressed the overriding benefit of the vaccines.“The facts are clear: this is an extremely rare side effect, and only an exceedingly small number of people will experience it after vaccination. Importantly, for the young people who do, most cases are mild, and individuals recover often on their own or with minimal treatment,” the statement said.There does seem to be a link between the Pfizer and Moderna shots and some cases of heart inflammation, experts said at a meeting Wednesday of an outside panel that advises the Centers for Disease Control and Prevention on vaccinations.The problem appears to be most common in young men after they receive their second of two doses, but it is nevertheless rare overall: There have been 323 confirmed reports of the inflammation in people younger than 30, and the vast majority recovered from their symptoms.That risk “seems to me, and to many others, to be much lower than the risk of COVID,” said Dr. Brian Feingold, a University of Pittsburgh heart specialist who is not a member of the panel.There have been nearly 2,800 COVID-19 deaths among adolescents and young adults, and more than 4,000 youths have suffered a dangerous condition called MIS-C that appears to be linked to the coronavirus. COVID-19 itself also can cause heart inflammation.The expert panel did not vote to change its recommendation to CDC that Americans as young as 12 get the shots.CDC officials said Wednesday that they plan to update their guidance to say that anyone who suffers the heart inflammation after one dose of the vaccine can defer a second shot. Meanwhile, the Food and Drug Administration is planning to put together a product warning that notes the risk.One of the first Americans diagnosed with vaccine-linked heart inflammation was Sean Morrison, a scientist in Dallas. Three days after his second dose, he developed intense pain in his chest that he said felt like a heart attack.He was hospitalized for four days as doctors investigated. They did not see any lingering effects, but they advised him avoid exercise so his heart could recover.Morrison, a stem cell biologist at the University of Texas Southwestern Medical Center, praised the vaccines as a crucial weapon in the battle against a virus that has killed about 600,000 Americans. But he also called for more research into the side effect.———The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

Rabid dog imported into US sparks multi-state investigation

Rabid dog imported into US sparks multi-state investigation

A rabid dog imported into the United States this month has sparked a public health investigation across several statesBy MIKE STOBBE AP Medical WriterJune 18, 2021, 10:57 PM• 2 min readShare to FacebookShare to TwitterEmail this articleNEW YORK — A rabid dog imported into the United States this month has sparked a public health investigation across several states.Health officials say a dog brought to the U.S. from Azerbaijan that ended up with a family in Chester County, Pennsylvania began acting strangely. It later tested positive for rabies and was euthanized. At least 12 people were exposed to the animal.The dog was one of 34 animals — 33 dogs and one cat — imported by an animal rescue organization from Azerbaijan to O’Hare International Airport in Chicago on June 10.The animals were not in the main cabin of the plane or main terminal of the airport. Travelers through O’Hare are not considered to be at risk, but health officials are checking to see if other animals in the shipment are infected and are still tracking down the pets’ new owners.Rabies no longer regularly spreads among dogs in the U.S., but imported animals are considered a risk for new outbreaks.Federal agencies are working with health officials in Pennsylvania, Illinois, Indiana, New Jersey, and New York on the investigation.The incident marks the fourth rabid dog imported into the U.S. since 2015. The three previous were rescue dogs that arrived with rabies vaccination certificates that were later found to be fraudulent.This week, the CDC announced that starting July 14 it will impose a year-long ban on dogs from more than 100 countries — including Azerbaijan — where rabies is still a problem. The ban is being imposed because of a spike in the number of puppies denied entry because they weren’t old enough to be fully vaccinated.———The Associated Press Health & Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.

More evidence suggests COVID-19 was in US by Christmas 2019

More evidence suggests COVID-19 was in US by Christmas 2019

A new analysis of blood samples from 24,000 Americans taken early last year is the latest and largest study to suggest that the new coronavirus popped up in the U.S. in December 2019 — weeks before cases were first recognized by health officialsBy MIKE STOBBE AP Medical WriterJune 15, 2021, 5:08 PM• 4 min readShare to FacebookShare to TwitterEmail this articleNEW YORK — A new analysis of blood samples from 24,000 Americans taken early last year is the latest and largest study to suggest that the new coronavirus popped up in the U.S. in December 2019 — weeks before cases were first recognized by health officials.The analysis is not definitive, and some experts remain skeptical, but federal health officials are increasingly accepting a timeline in which small numbers of COVID-19 infections may have occurred in the U.S. before the world ever became aware of a dangerous new virus erupting in China.“The studies are pretty consistent,” said Natalie Thornburg of the Centers for Disease Control and Prevention.“There was probably very rare and sporadic cases here earlier than we were aware of. But it was not widespread and didn’t become widespread until late February,” said Thornburg, principal investigator of the CDC’s respiratory virus immunology team.Such results underscore the need for countries to work together and identify newly emerging viruses as quickly and collaboratively as possible, she added.The pandemic coronavirus emerged in Wuhan, China in late 2019. Officially, the first U.S. infection to be identified was a traveler — a Washington state man who returned from Wuhan on Jan. 15 and sought help at a clinic on Jan. 19.CDC officials initially said the spark that started the U.S. outbreak arrived during a three-week window from mid-January to early February. But research since then — including some done by the CDC — has suggested a small number of infections occurred earlier.A CDC-led study published in December 2020 that analyzed 7,000 samples from American Red Cross blood donations suggested the virus infected some Americans as early as the middle of December 2019.The latest study, published Tuesday online by the journal Clinical Infectious Diseases, is by a team including researchers at the National Institutes of Health. They analyzed blood samples from more than 24,000 people across the country, collected in the first three months of 2020 as part of a long-term study called “All Of Us” that seeks to track 1 million Americans over years to study health.Like the CDC study, these researchers looked for antibodies in the blood that are taken as evidence of coronavirus infection, and can be detected as early as two weeks after a person is first infected.The researchers say seven study participants — three from Illinois, and one each from Massachusetts, Mississippi, Pennsylvania, and Wisconsin — were infected earlier than any COVID-19 case was originally reported in those states.One of the Illinois cases was infected as early as Christmas Eve, said Keri Althoff, an associate professor at the Johns Hopkins Bloomberg School of Public Health and the study’s lead author.It can be difficult to distinguish antibodies that neutralize SARS-CoV-2, the virus that causes COVID-19, from antibodies that fight other coronaviruses, including some that cause the common cold. Researchers in both the NIH and CDC studies used multiple types of tests to minimize false positive results, but some experts say it still is possible their 2019 positives were infections by other coronaviruses and not the pandemic strain.“While it is entirely plausible that the virus was introduced into the United States much earlier than is usually appreciated, it does not mean that this is necessarily strong enough evidence to change how we’re thinking about this,” said William Hanage, a Harvard University expert on disease dynamics.The NIH researchers have not followed up with study participants yet to see if any had traveled out of the U.S. prior to their infection. But they found it noteworthy that the seven did not live in or near New York City or Seattle, where the first wave of U.S. cases were concentrated.“The question is how did, and where did, the virus take seed,” Althoff said. The new study indicates “it probably seeded in multiple places in our country,” she added.———The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education. The AP is solely responsible for all content.